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Employer Solutions

Your health plan design is driving up costs, and you’re footing the bill. 

Health Plan Design Solutions

Pharmacy Benefit Strategies

Pharmacy Benefit Managers (PBMs) are driving up costs and limiting care—often without employers realizing it. Take back control by actively managing your PBM contract to ensure it aligns with your employees' health and your company's bottom line.

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Obesity Management

Obesity is a major driver of health costs and productivity loss—but it’s still often excluded from coverage. Nearly half of U.S. adults are affected, yet stigma, outdated policies, and limited access to treatment hold back progress. Employers can lead by covering evidence-based care: lifestyle counseling, medications, and surgery.

FIND SOlutions
The Cost of Obesity
Treatments
Stigma
Workplace Wellness

Excluding it from coverage harms health and business outcomes

Obesity raises the risk of over 200 conditions, including Type 2 diabetes (nearly 90% of people with Type 2 diabetes have overweight or obesity), heart disease, stroke, and 40% of cancers.

Treating obesity cuts the cost curve in half

Obesity costs employers $12,735/year in medical, absenteeism, presenteeism, and disability expenses, while OMMs coverage only costs $6,000/year. Tirzepatide has been shown to reduce the incidence of developing Type 2 diabetes by 94%. On average, people with diabetes incur annual medical expenditures of $19,736, of which approximately $12,022 is attributable to diabetes. After 2 years the medical cost trend of a patient taking GLP-1s was half that of the control group driven largely by a 44% reduction in major adverse cardiac events.

Obesity care must be inclusive and responsive to these disparities

Class II and III obesity disproportionately affect Black and Hispanic adults. Social determinants of health like income, education, and food access play a role and must be considered in care approaches.

Obesity’s Impact on Health EquityFact Sheet: Impact on Black AdultsFact Sheet: Impact on Hispanic Adults

Treatments for Obesity

While diet and exercise are key components of obesity management, they aren’t enough for everyone. Most people regain lost weight within two years—highlighting the need for lasting solutions. Employers can lead the fight against obesity by offering equitable, evidence-based care that includes covering lifestyle therapy, medications, and surgery—treatments proven to improve health and reduce long-term costs. Even modest weight loss (5-10%) provides major health benefits. Coverage of these proven treatments is lagging far behind the science.

Counseling options are effective and underused

Counseling that provides education and support facilitates long-term weight management. Medical nutritional therapy (MNT) offers structured dietary guidance, while intensive behavioral therapy (IBT) helps change habits and behaviors. These therapies are inexpensive, yet access to them is limited by most health plans.

OMMs are often covered for diabetes, not obesity

GLP-1s are hormone replacements that provide on average 14-25% weight loss. In addition, tirzepatide was shown to reduce Type 2 diabetes risk by up to 94%. These medications work better when combined with lifestyle management.

Patients still need medication and lifestyle management with surgery

Surgery is the most expensive treatment and yet the most commonly covered. Without lifestyle management and medications post-surgery, weight regain is common.

Addressing Stigma

Bias and stigma aren’t just personal; they’re built into systems
Despite the data, obesity remains vastly under-treated—largely due to stigma and misconceptions. Bias shows up in hiring, wages, healthcare, and wellness programs. It delays diagnoses, limits treatment access, and harms mental health, triggering stress responses that worsen obesity and chronic disease. Employers have an opportunity to shift the narrative by fostering weight-inclusive cultures. That includes recognizing weight bias, addressing bullying through policy, and designing wellness efforts that focus on health, not weight. Treating obesity starts with treating people with respect.

Workplace Wellness

Support health for all with inclusive, proven programsWellness programs should focus on reducing health risks like high blood pressure or A1C, not pounds lost, and reward healthy behaviors such as exercise and good nutrition. Employers should make wellness accessible to everyone by offering nutritious food options at work events, ensuring stairwells are safe and inviting, and creating a culture that supports all body sizes and health needs. Inclusive, stigma-free programs benefit all employees, at every size and health status.

Fiduciary Responsibility

Employers who don't manage the tactics of their PBMs are exposed to potential fiduciary liability for failing to protect their people. Explore real-world examples, legal updates, and the key steps you can take to strengthen your health plan today.

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Resources

Manage Diabetes Risk & Cost In Your Health Plan

The Diabetes Leadership Council and JDRF explore how employers can balance innovation in diabetes medicines, devices, and plan design with smart cost strategies.

Watch Webinar

Drug rebates under scrutiny: how prepared is your health plan?

With 10%-15% of health care costs spent on prescription drugs, it's important to understand the real cost impact of rebates.

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Four Ways to Lower the Cost of Drugs for Your Employees

No one buys drug insurance. We buy health insurance. Yet, the drug portion of that health plan can and should also be a strategic investment in your

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HR Benecast Episode 37

George Huntley, founding member and CEO of the Diabetes Leadership Council, shares how plan sponsors can develop a benefits strategy to help employees with diabetes and other chronic conditions, advice for PBM

Watch Episode

Maintenance is a Good Investment – Especially with Chronic Diseases like Diabetes

Most employers know that diabetes is a major cost driver for their health plans. However, many don’t actually know how

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Four Steps for Evaluating Your Plan’s Diabetes Coverage

Better health plan design can help remove barriers to care while also reducing costs for your company.

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Is your health plan covering the lowest cost drugs?

Generics and biosimilar drugs are available at a substantially lower price for many drugs but are often excluded from formularies by the very vendor we entrust to manage our costs.

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White Paper Highlighting Barriers to Access and Prioritizing Patient Choice

Diabetes is not a one-size-fits-all condition, yet outdated policies limit patient choice and access to modern, lifesaving technologies. 

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Are you or your clients running a health plan or a sick plan?

With health care costs rising to more than $13,000 per employee, smart, preventive approaches to chronic conditions like diabetes help control cost

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